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6421 Capitol Ave, Lodi Record ID PR0231706 <br /> 4/26/2021 UST Inspection <br /> Photo 2: The designated operator failed to check and note all required items on the visual inspection reports. The incorrect monitoring system <br /> certification date was used. <br /> A+sc rn nwas u�laUNOERGROUNO UNpER� <br /> °umenfatrvn0n araectl°n SFO RAGE FAntKDsrDRACE rANs< <br /> gttacpac urn Ill inemthep SII. INSPEC OPERATOR VISUAL IN <br /> Is them copy oiNa® ° a�aB^"CB'c rManrape`'nOn peen�N HISTORY SPECTION REPORT Ipoee 2 <br /> Has earn kodng a4atem ala d os�ty reporpyo VIII. AbARMmpin¢a appr¢pdalep? ---- Y H <br /> He alldm a vena` slnoefiEhedjn Woper ge�raa mrodev� HISTORY ❑ <br /> service cantainrrrenta ba gappmauieawnos ir'sp-.21barn as Y N NA <br /> Lt$t6vf0 °? amPa,that hoed aetl BerWrA r°fhia rePort)r wnd.dto eppropaaaely 7 ® ❑ ❑ <br /> f°Ya� afrca'+ral aVeak datecaon alarm alnca tha prevlou. ❑ ❑ ta <br /> Ons strbsfar as eft USTZ1: rhathave l+adrleatrd mspeayen,been respontl¢tl to by.Qu.afied UST ❑ ❑ <br /> and Ksenarvlx�rau,.Th. ar¢euanw„n,lereme <br /> Ix, aor. Orafarnm¢r,l sump.Hared below P'er4vW Map.cdan mdhvvv natMur <br /> is the contain UNDE wr.orme enact p, e.aenn9,a r�ne eo;wu, a iodr"�A°' °r'tle6if`' <br /> ` TsntnP tee, lama RUNgrORAGe TANK SYSTEM INSPECTION <br /> Tl: 43uand haze<daue <br /> Re 'tar M C^r rain pro ants a ce? <br /> T2:Re War SalveeFillill Y N cwda:mane sampto <br /> D ❑ Y N <br /> 171 l3 13 ❑ <br /> Are all sansars in eoetarn ❑ ❑ <br /> Is tite a ll r^en[sumps Inspected lacatetl to getect a taco 173 <br /> a ❑ ❑ <br /> Pi dontainar free of tlam'go water,debds,anti hazaraons supstance? <br /> TANK 10 T1;Re War Master p <br /> T2:Regular Salve N 0 T3:Supreme N ❑ <br /> lathsauprce&eeorabstmcadnaa ® 10 1 TA:Diesel N ❑ <br /> TA NKeD T1.Regular Master <br /> T2:Re ular Salve ® ❑ T3:Su tame ❑ <br /> 1s tna fit cap securely on the fid pipe? IR ❑ T4:Diesel 01❑ <br /> TANK ID T1:Regular Master <br /> T2:Regufar Salve ❑ T3:Supreme N ❑ <br /> Is the urMerdis ® ❑ T4:Diesel N ❑ <br /> penser congjnmen[free of damage,wafer,dapda,and hazardous substance? <br /> under-dispenser Contatnmentie Y N N Underdispenser CoMainmentku <br /> 1/2 N ❑ ❑ Y N N <br /> 3/4 ❑ ❑ ❑ <br /> 516 N ❑ ❑ ❑ Q ❑ <br /> 7/6 N ❑ ❑ ❑ ❑ ❑ <br /> 9/10 N ❑ ❑ ❑ ❑ ❑ <br /> 11!42 <br /> N ❑ ❑ ❑ ❑ ❑ <br /> 10 -1❑1 ❑ ❑ ❑ <br /> Are aft sensors in under-dispenser c"famn ent located to detect a leak at the eadiest a orturilbO ® ❑ ❑ <br /> X. TESTING AND MAINTENANCE Y N NA n.aTELgsT <br /> PERFORMED <br /> Has the monitoring system certification been completed wiVrin the pest 12 months? � ❑ 6!20120 <br /> Has the spill cootainertesdngbeen unmpleted yAthin Ne past 72 mbntha? ID 1:16/20120 <br /> Has the averfll!preven5on equipment inspection peen completed within the past 36 months? 119 in El 912119 <br /> Has the secondary containment testing been completed wilhin the past 36 months? ® ❑ 0 1124119 <br /> Has the tank tightness testing been completed vriden required timeframes? ❑ ❑ <br /> ix <br /> Yas the line tightness testing been completed vridtin the required timefremes7 ❑ ❑ <br /> ]ther re uired teshng I maintenance was com ieled within required limetrame. List test/maintenance items below <br /> TestlMalntenance:Air Quality test ❑ 6120120 <br /> Fest/Maintenance: ❑ ❑ <br /> Test/Maintenance: ❑ ❑ <br /> -Test/Maintenance: ❑ fl <br /> Test/Maintenance: ❑ ❑ <br /> Test I Maintenance' ❑ <br /> A FACILITY EMPLOYEE TRAINING y N <br /> 'e all individuals performing facility employee dulles received the required facility employee training within the past 12 months? ® ❑ <br /> e fac111ty has more components than this fame accommodates,additional copies of this page maybe attached. <br /> 4=No,NA w NMAppiirable,ID=Idenh'fiuiliori <br /> John Alaniz, REHS Page 2 of 8 <br />